clearn.png
Thursday June 4th, 2020 4:17AM

Trump rule could lead to big Medicaid cuts, governors warn

By The Associated Press
Related Articles
  Contact Editor

WASHINGTON (AP) — Governors of both parties are warning that a little-noticed regulation proposed by the Trump administration could lead to big cuts in Medicaid, restricting their ability to pay for health care for low-income Americans.

The arcane fiscal accountability rule proposed by the Centers for Medicare and Medicaid Services — or CMS — would tighten federal oversight and approval over complex financing strategies states have long used to help pay for their share of the $600 billion program. Also targeted are certain payments to hospitals that treat many low-income patients. Public comments closed last week amid a chorus of criticism from hospitals, nursing homes, insurers, doctors, and advocates for the poor.

Against the backdrop of an election year, governors are warning the administration of potentially dire consequences.

“States may be unable to adequately fund their Medicaid programs, which could lead to unintended consequences that would negatively impact Medicaid beneficiaries across the country,” wrote Govs. Kate Brown, D-Ore., and Charlie Baker, R-Mass., in official comments on behalf of National Governors Association.

But CMS administrator Seema Verma says the vast health care program needs closer scrutiny and has expressed concerns about “shady” financing schemes that abuse the system and drive up taxpayer costs.

In a statement Wednesday, Verma said her agency recognizes the “critical importance” of the state financing but said it has to lead to better value and improved care for Medicaid beneficiaries. Under the proposed rule, “we are increasing transparency, integrity and clarity,” she said.

An agency spokesman said the rule is not intended to reduce Medicaid payments.

But the policy comes from an administration that has repeatedly moved to scale back Medicaid. Trump has tried to repeal the program's Obama-era expansion, supported block grants that would cap federal spending, and allowed states to impose work requirements on Medicaid recipients.

The latest proposal could lead to cuts of $37 billion to $49 billion a year in total Medicaid spending, or 6% to 8% of program funds, according to a study by Manatt Health consultants for the American Hospital Association. Payments to hospitals could be cut as much as 17%.

A CMS spokesman said the agency doesn't believe those estimates are credible. In the rule, CMS says that the fiscal impact of its plan is “unknown.” Critics say the agency did not do a full analysis.

If the federal government curtails financing methods states now rely on, governors would have to seek broad tax increases, cut payments to hospitals and doctors, reduce benefits, restrict eligibility, or some combination of such measures. States can set their own Medicaid policies within federal requirements.

Medicaid covers more than 70 million people, or about 1 in 5 Americans. That includes many pregnant women, newborns, elderly nursing home residents, and severely disabled people. In states that have accepted the Affordable Care Act's Medicaid expansion it's also a mainstay of coverage for low-income adults.

“Medicaid is the backbone of the U.S. health care system; you weaken the backbone and the whole system gets scoliosis," said Matt Salo, head of the nonpartisan National Association of Medicaid Directors, which has also raised concerns.

Trade associations for hospitals and nursing homes are asking the administration to withdraw its proposal entirely. So is the American Medical Association, saying “access to care for Medicaid beneficiaries would be at risk and health outcomes for such patients could worsen.” Governors and the health insurance industry are asking the administration go back to the drawing board and gather more information before attempting such sweeping changes.

“These proposed cuts to providers and states are clearly part of an ongoing assault on Medicaid and will endanger Americans when they fall on tough times,” Sen. Ron Wyden of Oregon, top Democrat on the panel that oversees the program, said in a statement.

Overall the federal government pays about 60% of Medicaid costs, and states the rest. Medicaid ranks along with education as a top budget items for states. At issue are strategies that states use to raise their share of Medicaid spending, enabling them to tap federal matching funds that stretch the services they can provide.

They include:

— Business taxes on hospitals, nursing homes and insurers — also called “provider taxes.” The money raised is plowed back into Medicaid. The Trump administration says it is concerned that some of these arrangements skirt federal laws.

— Payments from local governments to a state that then help the state draw down federal Medicaid matching funds. The Trump administration says those payments must be funded with state or local tax revenues and currently that's not always clear.

Also in the cross-hairs of the proposed rule are Medicaid “supplemental”payments to hospitals that treat a large share of low-income patients. Those could be curtailed.

Governors and state Medicaid directors say they agree with the Trump administration's goal of greater accountability for Medicaid financing. But they're concerned the administration hasn't done its homework.

“Preempting states' authority and reducing states' flexibility within their Medicaid program will result in decreased access to care for many vulnerable Americans," wrote Govs. Brown and Baker.

The Trump administration says it is closely reviewing some 4,000 comments and will consider feedback before it decides on next steps. No timetable has been announced for a final decision.

  • Associated Categories: Associated Press (AP), AP Online Headlines - Washington, AP Health, AP Business, AP Health - Senior Health, AP Business - Industries, AP Business - Financial Services, AP Business - Health Care
© Copyright 2020 AccessWDUN.com
All rights reserved. This material may not be published, broadcast, rewritten, or redistributed without permission.
Plane skids off Istanbul runway, breaks apart; 139 hurt
A plane has skidded off the runway as it tried to land in bad weather in Istanbul, crashing into a field and breaking into pieces
2:47PM ( 8 minutes ago )
Trump rule could lead to big Medicaid cuts, governors warn
Governors of both parties are warning that a little-noticed regulation proposed by the Trump administration could lead to big cuts in Medicaid
2:45PM ( 11 minutes ago )
YouTube: Face recognition firm must stop harvesting videos
YouTube is demanding that a facial recognition company stop harvesting its videos to identify the people in them
2:38PM ( 17 minutes ago )
Associated Press (AP)
Merck to spin off assets with $6.5B in sales; 4Q profit up
Drugmaker Merck beat Wall Street's fourth-quarter profit expectations
1:20PM ( 1 hour ago )
Japan quarantines cruise ship as toll of new virus grows
Gloved and masked health workers in Japan have led people infected with a new virus off a cruise ship, while the rest of the 3,700 people on board face a two-week quarantine in their cabins
11:04AM ( 3 hours ago )
The Latest: WHO seeks $675M to fight new virus
The director-general of the World Health Organization is asking for $675 million to help countries address the expected spread of the new virus that emerged in China
10:58AM ( 3 hours ago )
AP Health
Plane skids off Istanbul runway; 120 hurt
A plane has skidded off the runway upon landing at Istanbul's Sabiha Gokcen airport, crashing into a field and breaking into at least three pieces
1:54PM ( 1 hour ago )
Plane skids off Istanbul runway, breaks up; 120 hurt
A plane has skidded off the runway upon landing at Istanbul's Sabiha Gokcen airport, crashing into a field and breaking into at least three pieces
1:21PM ( 1 hour ago )
2 leaders of Democratic convention host committee fired
The two leaders of Milwaukee's host committee for the 2020 Democratic National Convention have been fired amid allegations that they oversaw a toxic work environment
1:16PM ( 1 hour ago )
AP Business
Tricky trade-offs for states in Trump's new Medicaid offer
The Trump administration is offering states a new Medicaid deal: more control over health care spending on certain low-income residents
5:52PM ( 5 days ago )
Thorny trade-offs in Trump administration's Medicaid deal
The Trump administration is offering states a new Medicaid deal: more control over health care spending on certain low-income residents if they agree to a limit on how much the feds kick in
9:06AM ( 6 days ago )
Couple together for nearly 65 years die on the same day
A couple who had been together for nearly 65 years have died on the same day at a St. Louis-area nursing home
9:24AM ( 2 weeks ago )
AP Health - Senior Health
US stocks extend rally as companies report solid earnings
Stocks are extending their rally on Wall Street as investors assess the latest batch of solid corporate earnings reports and set aside fears about economic fallout from the virus outbreak that originated in China
11:51AM ( 3 hours ago )
US stocks extend rally as companies reports solid earnings
Stocks are extending their rally on Wall Street as investors assess the latest batch of solid corporate earnings reports and set aside fears about economic fallout from the virus outbreak that originated in China
10:38AM ( 4 hours ago )
German state gets new governor, with far-right votes
A pro-business politician has been elected unexpectedly as the governor of an eastern German state after a far-right party threw its votes behind him
10:20AM ( 4 hours ago )
AP Business - Industries
Asian shares rise, Europe falls after China moves on virus
European indexes are falling in early trading after Asian shares rose on optimism that China's latest actions may help curtail some of the expected economic damage from the virus outbreak
3:36AM ( 11 hours ago )
Australian bank official says virus is an economic unknown
The head of Australia's central bank says the nation's deadly wildfires will have no impact on economic growth this year but it was too early to know the impact of a new virus
1:56AM ( 13 hours ago )
Asian shares up on China efforts despite virus worries
Asian shares are rising on optimism that China's latest actions may help curtail some of the expected economic damage from the virus outbreak
1:37AM ( 13 hours ago )
AP Business - Financial Services
1st US patient with new virus leaves hospital, is recovering
The man who became the first U.S. patient with the new virus from China has left the hospital and says in a statement that he is getting better and looks forward to life returning to normal
5:25PM ( 1 day ago )
Stocks open higher on Wall Street; China's main market dives
Stocks are opening solidly higher on Wall Street as the market finds its footing after two weeks of losses amid uncertainty over the virus outbreak that began in China
9:44AM ( 2 days ago )
Chinese market dives 8% but other world stocks stable
World stock markets are mixed after the Shanghai Composite index tumbled nearly 8% as Chinese markets reopened after days of bad news about a virus that has spread to more than 20 countries
7:51AM ( 2 days ago )
AP Business - Health Care
Plane skids off Istanbul runway, breaks apart; 139 hurt
A plane has skidded off the runway as it tried to land in bad weather in Istanbul, crashing into a field and breaking into pieces
2:47PM ( 8 minutes ago )
YouTube: Face recognition firm must stop harvesting videos
YouTube is demanding that a facial recognition company stop harvesting its videos to identify the people in them
2:38PM ( 17 minutes ago )
Sen. Romney breaks with GOP, will vote to convict Trump
Utah Sen. Mitt Romney says he will vote to convict President Donald Trump
2:36PM ( 19 minutes ago )
Oscar Predictions: Can 'Parasite' upset '1917'?
Many of the likely winners at the 92nd Academy Awards seem set in stone: Joaquin Phoenix, Renee Zellweger, Brad Pitt and Laura Dern are entrenched as the acting favorites
2:31PM ( 24 minutes ago )
Trump acquittal on track, though Romney to vote to convict
President Donald Trump is on the verge of acquittal by the Senate
2:28PM ( 27 minutes ago )